Abstract
Increasingly, studies have investigated cognitive functioning from the perspective of acute state- to remitted phases of Major Depressive Disorder (MDD). Some cognitive deficits observed in the symptomatic phase persist in remission as traits or scars. The etiological origin and clinical consequences of the neurocognitive profiles reported in the literature are still unclear and may vary across populations. Deficits are suspected to influence the association between MDD and neurodegenerative disorders and could thus be of particular clinical consequence. The aim of this review is to describe the clinical neuropsychological profile in MDD and how it is related to research during the past decade on cognitive deficits in MDD from a state, trait, and scar perspective. This review, with a clinical perspective, investigates research from the past decade regarding cognitive functioning in MDD in a long-term perspective. We focus on the clinical manifestation of deficits, and the potential neurodegenerative consequences of the neurocognitive profile in MDD. Searches in Medline, PsycINFO and Embase were conducted targeting articles published between 2010 and 2020. Examination of the evidence for long-lasting neurocognitive deficits in major depression within the cognitive domains of Memory, Executive Functions, Attention, and Processing Speed was conducted and was interpreted in the context of the State, Scar and Trait hypotheses. Defining the neurocognitive profiles in MDD will have consequences for personalized evaluation and treatment of residual cognitive symptoms, and etiological understanding of mood disorders, and treatments could potentially reduce or delay the development of neurodegenerative disorders.
Highlights
Cognitive deficits are a central component in Major Depressive Disorder (MDD) (1–3)
Many former patients relate these memory problems to possible brain damage or dementia, leading to a negative impact on self-representation, rumination and coping. Such an interpretation combined with the lack of correct knowledge regarding the role and origin of residual cognitive impairment might lead to an increased risk of relapse and new episodes
Xu et al (47) reported immediate visual memory impairment (WMS-R Immediate Visual Reproduction; copying figure after 10 s exposure) in patients in the depressed state and in remission compared to healthy controls, suggesting visual memory deficits may be a trait for mood disorders
Summary
Cognitive deficits are a central component in Major Depressive Disorder (MDD) (1–3). There is considerable complexity when it comes to understanding cognitive deficits in MDD in the current literature. It is clear that cognitive impairment in depression is a substantial problem associated with severe difficulties in occupational, social, and interpersonal functioning (8–10). A growing pool of literature during the past decade shows that impairment in cognitive functioning persists in remission and worsens over time with repeated episodes (14), and age (15). Given the wealth of studies showing cognitive deficits in MDD, in addition to important clinical consequences of this disorder, it is important to draw on the literature for potential novel etiological and clinical implications, to prevent and remediate cognitive decline
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